House Calls – Toe Injuries & Flu Shots

Dear HOUSE Calls, Last week I smashed my big toe. I don’t think I broke it, but it looks like there is blood trapped under the nail. Will this resolve on its own?

Ouch! the fancy name for this problem is a sub-ungual hematoma. If the hematoma is big and painful, we can relieve it by piercing the nail with a cautery instrument or a hot needle. If it does not hurt much, you can just let it run its course. It may take a month or more to resolve, and you may lose the nail, but it is not dangerous. Of course, we can’t comment on the injury to the toe. Most toe fractures heal without incident, but sometimes big toe fractures need more care, so see your doctor if there is any doubt.

Dear HOUSE Calls, I had a flu shot last month and now I’ve had chest and sinus congestion for a week. Do you think I got a bad shot?

That is a really common question about flu shots. First of all, the flu shot only protects us from influenza though what you have might be the flu, it is more likely a garden-variety viral infection (like an adenovirus or rhinovirus). That does not mean it’s not miserable, just that it’s not the flu. Flu is typically characterized by fever, dry cough and muscle aches. Flu is more likely to result in complications like pneumonia or even death than these other viral infections. That is really the main reason we encourage flu shots. Second, you should know that not all flu shots cover or match with all strains of the flu. Infection experts study trends in circulating flu strains and make predictions six to 12 months before flu season as to what are likely to be the most common circulating strains of flu in the upcoming season. these experts are right most of the time, but not always, and there are always less-common circulating strains. Lastly, not all people will develop a robust immune response to all flu vaccines. the immune response tends to be better if you have received the vaccine in the past. So the short answer to your question is no, we doubt you got a bad shot. However, you probably don’t have the flu. Good for you for getting your flu shot and protecting yourself and those around you from the flu.